Provider Demographics
NPI:1356837116
Name:MAYER, REINE RENELIA
Entity Type:Individual
Prefix:MS
First Name:REINE
Middle Name:RENELIA
Last Name:MAYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5640 WHITFIELD CHAPEL RD APT 103
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2558
Mailing Address - Country:US
Mailing Address - Phone:240-708-2087
Mailing Address - Fax:
Practice Address - Street 1:5640 WHITFIELD CHAPEL ROAD APT 103
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2070
Practice Address - Country:US
Practice Address - Phone:240-708-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13734374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide